There are four decisions no dog owner can avoid. You will be making these lifestyle choices for your dog regardless of whether you spend time researching the available information to ensure they are well-considered and informed decisions or whether they are simply choices of omission - we are certainly all prone to taking the easy road of doing things the way we always have.

A few months ago, I wrote about the comprehensive changes in our approach to vaccinating dogs that have led to a situation where routine vaccines will in most cases now be for puppies only as the adult 'boosters' of the past are replaced with titre tests. 

Today, I want to touch upon another area where changes are currently sweeping across the veterinary community, namely the issue of neutering.

Cultural differences play a big role when new dog owners decide whether to have their dog neutered or to leave him or her intact. In some parts of the world, neutering of healthy dogs is considered unethical. In Norway routine neutering is downright illegal meaning that around 99% of all dogs in Norway are left intact. At the same time, there are parts of the world where neutering has historically been strongly encouraged and perhaps even regarded as a prerequisite for responsible dog ownership.

Until five years ago many vets certainly considered routine neutering as being in the general interest of the dog. The most serious side effect was believed to be the risk of urinary incontinence ('spay incontinence') in bitches. Then, in 2013, a bombshell was dropped in the form of a major study from the UC Davis school of veterinary medicine. The study revealed what no one had previously suspected, that neutered dogs of both sexes have a much greater risk of developing joint disease as well as several different types of cancer compared to intact dogs. In the frenzy of studies that have followed, increased risks of allergies, autoimmune disorders and thyroid disease have been added to the list of side effects and though research is ongoing, it is certainly safe to say that this startling new evidence should make anyone think twice before neutering.

For now, here's what we know:

Male dogs:


Health benefits and risks

Health benefits of castration

  • A castrated dog will have a reduced risk of benign prostate hyperplasia in old age and, of course, no risk of testicular cancer. There are, however, no overriding health-based arguments for routine castration.

 Health ill effects of castration

  • Increased risk of joint disease (cruciate ligament disease, hip dysplasia and elbow dysplasia)
  • Increased risk of several types of cancer (lymphoma, hemangiosarcoma, osteosarcoma, mast cell tumours)
  • increased risk of a range of immune-mediated diseases, such as allergies and auto-immune disease

Female dogs:

Bitch spay

Health benefits and risks

Health benefits of spaying

  • No risk of pyometra (womb infections)
  • Reduced risk of mammary tumours (breast cancer)

 Health ill effects of spaying

  • Risk of urinary incontinence and increased risk of cystitis
  • Increased risk of joint disease (cruciate ligament disease, hip dysplasia and elbow dysplasia)
  • Increased risk of several types of cancer (lymphoma, hemangiosarcoma, osteosarcoma, mast cell tumours)
  • Increased risk of a range of immune-mediated diseases, such as allergies and auto-immune disease

Please note that the above information relates to routine neutering of healthy dogs only. If your dog has an illness (such as testicular cancer or a womb infection) this may tip the scale in favour of neutering. In the case of healthy dogs, however, it is now clear that neutering will have an overall detrimental effect on the health of male dogs. It also looks like bitches are healthier when left intact, though this requires the carers to look out for signs of mammary tumours and pyometra.

Research is very much ongoing. One aspect, for instance, that it turns out we don't understand as well as we thought we did prior to 2013 is the relevance of the age of neutering. Whatever new evidence surfaces in the future, there can be no doubt that the way we look out for our dogs is changing fast.


Published in Blog
Sunday, 18 November 2018 12:24

Case Reports: Dietary Success with Nutriscan

Balanced nutrition is now recognized as the key factor in providing for health and longevity of human and animal populations. Achieving this balance depends upon each individual’s genetic and geographical needs and lifestyle.  However, nutritional imbalance and food intolerances are seen more than ever today, with the rising number of environmental challenges,

The following three case examples illustrate how diagnosing food intolerances with Nutriscan and then removing any reactive foods from a pet’s diet has a successful outcome:

Case #1

Brandy   5 years old, entire female, 40 pounds, Nova Scotia Duck Tolling Retriever

  • Very itchy puppy scratching, skin rashes and loss of patches of hair
  • Hypoallergenic shampoos and wearing a T-shirt didn’t help much
  • Reactive foods identified with Nutriscan and removed
  • 2 weeks later scratching abated
  • More reactive foods arose, especially soy
  • Strict dietary control has kept her healthy as an adult

Healthy and happy after reactive foods were removed from her diet



Case #2

Rosie   6 years old, spayed female, 35 pounds, Border Collie mix

  • Intense itching on limbs and feet, dry cracked foot pads, constant rubbing of face, muzzle and around eyes
  • 10 Nutriscan reactive foods removed from diet
  • 3-5 weeks later, itching and rubbing subsiding; face and limb redness fading and healing; foot pads softened
  • 2 months later, almost healed and happy
  • Inhalant and contact allergens addressed as well

Red and itchy face before Nutriscan testing

Rosie - Before


Face almost completely healed after removing foods identified by Nutriscan as reactive


Rosie - After


Case #3

Jojan   19 years old, spayed female, Silver Domestic Shorthaired Cat

  • Experienced intermittent weight loss and poor appetite
  • Thyroid profile was normal
  • Food reactivities on Nutriscan were Cow’s Milk, Corn, and White-Colored Fish
  • All sources of these foods in diet and supplements (including cornstarch) were removed
  • Gave only homemade diet of grass-fed meats plus some vegetables and blueberries
  • Mood and appetite improved and has remained good

Sleek haircoat, calm, and good weight after Nutriscan adjustment of diet




The debate about the most accurate and predictive clinical and laboratory diagnosis of food adverse reactions in companion animals has been ongoing for two decades.  Should we rely upon the patient’s clinical response and outcome, patch testing, extended food elimination trials, the presence of allergen-specific serum antibodies, direct bowel surface food-sensitivity testing and fecal immunoglobulin levels, or the novel validated saliva-based Nutriscan test described here? 

Food patch testing was recently reported to be reliable as a tool to identify suitable ingredients for an elimination diet due to its high negative predictability. However, patch testing also is time-consuming, expensive and because of its low positive predictive value cannot identify offending allergens. Most pet owners would prefer faster and easier performed diagnostic tools.

Intradermal tests with food components or tests for food-specific serum immunity have so far failed to reliably identify dogs with adverse food reactions and thus cannot be recommended for this diagnosis in clinical practice. Measuring serum antibody levels to specific food ingredients does not correlate well with clinical patient outcomes or dietary re-challenge studies.

Many commercial pet foods contain meat and flavorings not listed or specified on the label. Current studies have examined the presence of these undeclared ingredients which:

  • critically assessed published discrepancies between ingredients and labeling in commercial pet foods, including those with “novel” or “limited” ingredients and containing micronized hydrolysates
  • found that the median mislabeling was 45 % of tested diets with a range of 33-83% for the “novel/limited” ingredients ones that are used for food elimination trials, and one hydrolyzed diet

The authors concluded that before ruling out a food component as an allergen, a novel protein home-made diet trial should be performed, if the dog is unresponsive to a commercial regimen.

The data summarized above are further confounded by the fact that many pets also receive a variety of supplements, preventive pharmaceuticals such as those for heartworm, flea and tick exposures, as well as puppy and periodic booster vaccines. These products usually contain meat, especially beef, pork and chicken, as well as other flavorings and several types of fish oils, and nearly all vaccines contain fetal calf serum.

The problem is more complicated when veterinary therapeutic and supplement items and over-the-counter products may not accurately list the ingredients or their antigen sources on the label or product insert. When recommending food elimination trials, only non-flavored oral or topical therapies, pill pockets, and supplements should be used. Additionally, gelatin capsules may contain either beef or pork proteins and should not be administered during a trial.

In summary, Hemopet’s patented test for food-specific antibodies in saliva is available worldwide for dogs, cats and horses. The test is easy to perform and noninvasive, and thus is very acceptable to pet owners.  The cases described above attest to its reliability and efficacy.

For more information on Nutriscan, please visit the official website at

Selected Reading

Dodds WJ. Diagnosis of canine food sensitivity and intolerance using saliva: report of outcomes. J Am Hol Vet Med Assoc 2017/2018; 49:32-43.

Dodds WJ. Challenges in food quality, safety and intolerances. Timely Top Clin Immunol 2018; 2 (2):16-20.

Olivry T, Mueller RS.  Critically appraised topic on adverse food reactions of companion animals (5): discrepancies between ingredients and labeling in commercial pet foods.  BMC Vet Res 2018: 14:24-28.


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Dogs and cats, like humans, are susceptible to certain diseases transmitted by viruses and bacteria. To protect against these invaders, the body has a number of defense mechanisms. The first barriers are the skin and mucous membranes that are found in the airways and intestines. Saliva and stomach acids also ensure that certain pathogens are cleaned up. In addition, there are the white blood cells that move through the body and attack intruders that have penetrated the first barriers.

Finally, the body has an immune system that focuses on specific pathogens. The parvovirus is an example of this. The body’s immune system is subdivided into cellular and humoral defenses. In the case of cellular defenses, viruses and certain bacteria that have already penetrated into the dog's cells are rendered harmless. The humoral defense takes place in the blood and body fluids. An important part of titer testing is the presence of different types of antibodies. The most important for titer determination being the IgG antibodies.

In dogs, we can measure these IgG antibodies in the blood for the following diseases: Infectious Canine Hepatitis, Parvo and Distemper. For cats, we measure antibodies for Feline Panleukopenia, Herpes and Calici.

What does such titer determination exactly mean?

The titer of antibodies in blood is the dilution of the blood, whereby these antibodies are still detectable. The blood is diluted and if antibodies are still detected at the highest dilution, this is a high titer. If antibodies are detected at low dilution, this is a low titer.

What is important to know is that the height of the titers is not important, but only the presence of the antibodies. There is no point in vaccinating a dog that still has antibodies that have developed after a previous vaccination. The titers will not be increased. In such a case, we are talking about unnecessary and / or superfluous vaccination.

There are a number of options for determining titers. This can be done in a laboratory by using virus neutralization or a hemagglutination inhibition test. Also available is test that vets can perform themselves. This is VacciCheck and is accepted by WSAVA as reliable, with a good predictive value.


VacciCheck is an in-clinic ELISA-titer test that measures the antibodies in the above-mentioned diseases.

ELISA is the abbreviation for Enzyme-linked ImmunoSorbent Assay. It is a test (assay) in which an antibody reacts (immuno) to an antigen (for example parvovirus) that is bound to a plastic surface (sorbent). To make this reaction measurable, an enzyme (enzyme-linked) is used to generate a color reaction.

The great advantage of this test is that only one drop of blood is needed, and that the result is known after 23 minutes. It is not harmful to the animal and less painful than a vaccination. The result is shown on a white plastic strip with a maximum of 4 gray dots, the upper of which is the positive reference dot. It always gives the same value regardless of the color (3). Then follow the dots for the diseases on which are tested. If the dots are the same color or darker than this reference dot, this means that the titers are positive. A shade lighter than the reference dot is weak positive, the rest is negative. The values ​​range from 0 to 6. Zero and one is negative, two is weak positive, three and four is positive, five and six is high positive.

A different titer can therefore be measured for each disease and, depending on the titer height it would be necessary or not, to vaccinate.

As we obviously want to ensure that our animals do not get sick and can not infect other animals, we will vaccinate at a score of 0 and 1.


If the titers for Hepatitis are negative, then we have no choice other than giving the dog the complete cocktail (DHP). The vaccine against hepatitis is not available separately.

If the titers for Parvo are too low, then we vaccinate the dog with a separate Parvo (P) vaccine.

If the titers for Distemper are too low, then we vaccinate the dog with a cocktail of Distemper and Parvo (DP). In some countries, the Distemper vaccine is not available separately (e.g. Belgium and The Netherlands).


If the titers for Panleukopenia are negative, our only choice is to give the cat the full cocktail (Panleukopenia, Calici and Herpes). The vaccine against Panleukopenia is not separately available.

If the titers for Calici and Herpes are too low, then we vaccinate the cat with a cocktail of Calici and Herpes.

It would be wonderful if the vaccine producers were to market individual vaccines. The demand for Testing antibiody titers (or titer determinations) is increasing at an amazing rate. The vaccine producers could respond perfectly to this, ensuring that dogs and cats are not superfluously vaccinated.

Titer determination makes sense in many aspects, the most important of all, listed below.

When breeding dogs and cats, it would be wise to have titer determination well before the pregnancy to see if the bitch or female cat has antibodies. If positive, then chances are that the pups and kittens will receive these antibodies via the colostrum and are maternally protected. If the bitch or cat has no antibodies, she can still be vaccinated before the pregnancy

  • Titer determination is highly recommended for pups and kittens, so determining the right time for effective vaccination.
  • Already vaccinated dogs and cats can also benefit. From 3 to 4 weeks after each vaccination, a titer determination can be made to see if the vaccination has actually been effective. Even if the package leaflet of a vaccine indicates that it has been registered for 3 years, one still does not know, without titer determination, if the vaccination has ensured that your dog or cat is protected. In addition, there are also animals who do not respond to a vaccination in any case. This is known as “non-responders”.
  • In the vaccination schedule for all dogs and cats to see if a (re) vaccination is needed.
  • Dogs and cats with an unknown vaccination status such as animals from abroad, animals that are found, and go to a shelter etc., would certainly benefit from VacciCheck testing. Titer testing of pups and kittens would be good for the general pet population. For example, For example, there are often doubts if puppies and kittens coming from Eastern European puppy or kitten farms have been correctly vaccinated. In this case titer testing gives us a clear answer. It is the same case with pups and kittens with false vaccine labels which are brought into Belgium and the Netherlands. Distemper and Parvo are prevalent in Eastern Europe and pose a serious threat to our pet population.
  • VacciCheck, as a titer test, will determine whether dogs and cats have been in contact with a particular disease and have perhaps contracted it.
  • For dogs and cats who have had adverse effects at a previous vaccination, for example, an allergic reaction.
  • Sick animals, and / or animals on medication, that suppresses the immune system, would do well with titer testing. Most medication package leaflets suggest that sick animals may not be vaccinated.
  • Titer testing on older pets is valuable.

It is important that the veterinarian officially states the titration in the European passport of the dog or cat. The values per disease must be stated, as well as the date of titering and the date when a titer determination must be made again. In many cases, the strip is stuck in the passport as proof.

In short, the titer determination is the ultimate means of testing as to whether your pet is protected against infectious and fatal diseases, determining the right time for vaccinating and / or avoiding unnecessary vaccinations.

There are numerous occasions where our pet animals come together - at shows, competitions, animal events, dog schools or dog parks, and we would not want our pet to develop any illness, so unnecessary, so easy to prevent.

 The vaccine label in a cat and dog passport, says nothing about the degree of protection.

 Measuring is knowing! We do want to know that our pets are protected.

Published in Blog
Sunday, 29 July 2018 06:35

Titer Testing in Puppies

Most puppies are vaccinated several times at 6, 9 and 12 weeks, as it is known that maternally derived antibodies can cause a vaccination to fail.  However, is that sufficient?  How do you know whether your dog is protected?

Pups are given, right after birth, via the first mother's milk, (colostrum) antibodies, that will protect against infectious and fatal diseases. These so-called maternally derived antibodies are temporary and disappear gradually, but can be present in the blood of the pups for up to 20 weeks or longer.  If, however, the mother dog has no, or too few antibodies, the pups will not get them through the colostrum and are unprotected!  It is important to protect puppies at the right time by means of a vaccination that stimulates the body to produce antibodies. This ensures permanent immunity.

The goal of a vaccination is to make dogs immune to certain diseases. However, it is a misconception to think that all animals, that have been vaccinated, are actually protected. A vaccination does not automatically lead to protection in young animals, that are still protected by maternally derived antibodies. In the Netherlands and Belgium, pups are usually vaccinated at 6, 9 and 12 weeks. The last vaccine of the puppy vaccination schedule will be administered around the age of 1 year, and then every 3 years they are vaccinated against infectious hepatitis, parvo and distemper.

Most pups are vaccinated several times, because it is known that maternally derived antibodies can block a vaccination. By administering a vaccine regularly every 3 weeks, there is a chance that one will catch. The problem lies in the fact that most puppies get their last vaccination at 12 weeks. As maternal immunity can last up to 20 weeks, and sometimes even longer, there is a big chance that they will walk around unprotected for up to 1 year, the age at which they receive the last vaccination of the vaccination schedule. People mistakenly think that their dog is optimally protected by this vaccination, but there is still at risk of contracting and spreading diseases. The dogs will then go unprotected to dog schools, boarding kennels, shows, competitions, animal events, dog parks and so on.

Optimal vaccination schedules

It would be much better, and more responsible, to adjust the current vaccination schedule according to the vaccination guidelines of the WSAVA. The WSAVA is a scientific committee, which sets out guidelines worldwide regarding the vaccinations of dogs and cats. In these guidelines, it is stated, that among other things, it is not wise to administer the last vaccination before the age of 16 weeks.  There are two possibilities:

  1. A titer determination at 20 weeks. If the result is positive, the dog does not need to receive extra vaccination and the animal can be tested again after a certain period, depending on the result.
  2. To advance the vaccination normally given at 1 year, to 26 weeks. This is to prevent the animal from walking around unprotected until the age of 1 year.

Most puppy buyers receive a puppy that has been vaccinated once in the litter. Such a puppy can be tested 3 weeks after the vaccination. At that moment, it is not always clear whether the antibodies, that are being measured, come from the mother or from the vaccine. Therefore, a few weeks later, a new titer test is required. If the titers have dropped, then it is certain that these are maternally derived antibodies. Depending on the level of the antibodies (antibody titers) at that time, the pup can then be vaccinated or be retested at intervals of a few weeks, when they are sufficiently low to vaccinate successfully. If the titers remained the same, then this is a sign that the vaccination has been successful.  Unfortunately, most puppies in the Netherlands and Belgium are usually only vaccinated against distemper and parvo, so they still have to be vaccinated with a cocktail that also contains infectious hepatitis.

Titer first

The best and most effective method is to titer test a pup, who has not yet been vaccinated, just before it leaves the litter. If the test shows that sufficient maternally derived antibodies are still present, vaccination is pointless, as the antibodies will neutralize the vaccine. You would then retest the pup, who is probably already with the new owner, after about 3 weeks. If the level of antibodies has declined below the protective level and the level at which a vaccination can immunize, a cocktail containing modified live viruses of infectious hepatitis, parvo and distemper has to be administered.

Subsequently, a titer test is performed about 3 to 4 weeks after this vaccination, to see if the puppy actually has enough antibodies in the blood, and is protected against the diseases mentioned. If this is the case, it means that the dog is immunized and fully protected against the mentioned diseases, by just one vaccination. As the animal is still very young and the immune system has not yet fully developed, a year later it makes sense to test it again to see if the protection is still good. If this is the case, titer testing can be performed triennially, according to the WSAVA guidelines.

The most commonly used titer test is VacciCheck. This is a reliable in-house test which can be performed by the veterinarian himself. Only a very small drop of blood is needed and the result is known within half an hour. The veterinarian must indicate in the vaccination pet passport how long the dog will be protected and thus, a validity period is linked to the declaration, according to Dibevo, KNMvD, NVWA and KMSH.

Published in Blog
Thursday, 21 June 2018 09:48

Four choices you make for your dog

-Veterinarian and author Lise Hansen on recent changes in cutting-edge healthcare for dogs

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